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Executive Summary

This report responds to Section 3134(a) of the National Defense Authorization Act for Fiscal 

Year 2004, which provided for the National Institute for Occupational Safety and Health 

(NIOSH) to report on its access to information required for radiation dose reconstructions 

under the Energy Employees Occupational Illness Compensation Program Act (EEOICPA). 

The report describes the information required to conduct such dose reconstructions and 

explains in detail the matters that can adversely affect the ability of NIOSH to obtain the 

information in a timely, accurate, and complete manner. The report addresses these matters 

in Section III of the report with respect to the primary sources of such information, which 

include the Department of Labor (DOL), the Department of Energy (DOE), sources of 

information on Atomic Weapons Employers, and claimants. These matters are also 

addressed in context in Section IV of the report, which describes the dose reconstruction 

process and the amount of time provided for each component of this process, and identifies 

when adverse matters can arise and delay the process. The report also provides the following 

data on performance of the dose reconstruction program in relation to matters addressed in 

this report, as follows: 

Total Number of Claims Requiring Dose Reconstruction

As of January 15, 2004 NIOSH had received 15,191 cases for dose reconstruction from the 

DOL. Attachment 2 provides a site-specific breakdown of these cases. 

Total Number of Dose Reconstructions Adversely Affected by Matters Addressed in this 

Report

Almost all of the 15,191 cases received from DOL as of January 15, 2004 have been 

adversely affected by one or more of the matters addressed in this report, resulting in a delay 

of the dose reconstruction. As indicated in Section IV of this report, a substantial proportion 

of cases would have been likely to require more than 150 days for completion without the 

occurrence of any delay, to provide for the full rights and involvement of claimants and/or 

the complexity of the particular dose reconstruction. 
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I. Introduction 

The Energy Employees Occupational Illness Compensation Program Act (EEOICPA), 42 

U.S.C. §§ 7384-7385, authorized a compensation program to provide a lump sum payment of 

$150,000 and prospective medical benefits as compensation to covered employees suffering 

from designated illnesses incurred as a result of their exposure to radiation, beryllium, or 

silica while in the performance of duty for the Department of Energy (DOE) and certain of its 

vendors, contractors and subcontractors. This legislation also provided for payment of 

compensation for certain survivors of these covered employees. The Department of Labor 

(DOL) has primary responsibility for administering this compensation program, assisted by 

the Department of Health and Human Services (DHHS), DOE, and the Department of 

Justice. DOL began accepting claims for compensation under EEOICPA in July 2001. 

EEOICPA required the establishment of a radiation dose reconstruction program to estimate 

the radiation doses of most cancer claimants. These dose estimates are used by DOL to 

assess the likelihood that an employee with cancer developed that cancer as a result of 

exposure to radiation in performing his or her duty at a DOE facility or an Atomic Weapons 

Employer (AWE) facility. Within DHHS, the Centers for Disease Control and Prevention’s 

National Institute for Occupational Safety and Health (NIOSH) conducts the radiation dose 

reconstructions for cancer claims for which EEOICPA requires dose reconstructions. 

NIOSH develops these dose reconstructions based on information obtained from DOE, DOL, 

EEOICPA claimants, and other sources. Once completed, NIOSH transmits the dose 

reconstruction to DOL for use in making a final decision on the claim. 

Section 3134(a) of the National Defense Authorization Act for Fiscal Year 2004 provides as 

follows: 

 

a) REPORT ON ACCESS TO INFORMATION FOR PERFORMANCE OF 

RADIATION DOSE RECONSTRUCTIONS.-(1) Not later than 90 days after the 

date of the enactment of this Act, the National Institute for Occupational Safety and 

Health shall submit to Congress a report on the ability of the Institute to obtain, in a 

timely, accurate, and complete manner, information necessary for the purpose of 

carrying out radiation dose reconstructions under the Energy Employees 

Occupational Illness Compensation Program Act of 2000 (42 U.S.C. 7384 et seq.), 

including information requested from any element of the Department of Energy. 

(2) The report shall include the following: 

(A) An identification of each matter adversely affecting the ability of the Institute to 

obtain information described in paragraph (1) in a timely, accurate, and complete 

manner. 

(B) For each facility with respect to which the Institute is carrying out one or more 

dose reconstructions described in paragraph (1)- 

(i) a specification of the total number of claims requiring dose reconstruction; 

(ii) a specification of the number of claims for which dose reconstruction has been 

adversely affected by any matter identified under paragraph (1); and 

(iii) a specification of the number of claims requiring dose reconstruction for which, 

because of any matter identified under paragraph (1), dose reconstruction has not 
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been completed within 150 days after the date on which the Secretary of Labor 

submitted the claim to the Secretary of Health and Human Services. 

The following report describes the information necessary to perform dose reconstructions, 

identifies matters that have adversely affected the ability of NIOSH to obtain necessary 

information in a timely, accurate and complete manner, and provides an overview of the dose 

reconstruction process to provide a context for understanding the findings of this report. In 

addition, the report provides requested information, to the extent feasible, on the total number 

of cases1

 requiring dose reconstruction, the number of cases for which dose reconstruction 

has been adversely affected by the inability to obtain necessary information in a timely, 

accurate and complete manner, and a specification of the number of cases requiring dose 

reconstruction for which dose reconstruction has not been completed within 150 days after 

the date on which DOL submitted the case to NIOSH. 

II. Information Necessary to Complete Radiation Dose Reconstruction Under 

EEOICPA 

Overview on Information Required for Dose Reconstructions

Under EEOICPA and Executive Order 13179, NIOSH conducts dose reconstructions relying 

primarily on information obtained from DOL, DOE, AWEs, and claimants, while using the 

science-based knowledge and practices of dose reconstruction. The information obtained 

from DOE and AWEs includes data such as individual radiation dosimetry records, area 

radiation monitoring records, and process descriptions of tasks performed. Although 

individual dosimetry records are the most desirable information for completing dose 

reconstructions, such information is not required by EEOICPA and is not typically essential 

scientifically. For example, when individual dosimetry records are not available or are 

incomplete, dose reconstructions may be completed through the use of area monitoring, 

process descriptions, and other information summarized in site profiles prepared by NIOSH, 

together with information on the individual’s work history. Dose reconstructions conducted 

under these circumstances make use of claimant-favorable assumptions to avoid 

underestimating radiation doses. Consequently, such dose reconstructions typically estimate 

radiation doses that are substantially higher than those that are likely to have been incurred 

by the employees. 

The type and amount of information necessary to initiate a dose reconstruction is highly 

dependent on case-specific matters. For example, dose reconstructions for a cancer that has 

been associated in epidemiological research studies with lower doses of radiation, such as 

certain types of leukemia, might be completed by summing the original individual 

monitoring data provided by DOE, without further technical analysis or data collection. This 

 

1

 In this report, the term “case” is used instead of “claim” to avoid confusing the count of dose reconstructions, 

since there are often multiple survivor claimants, each with a claim, when the DOE or AWE employee is 

deceased. Each DOE or AWE employee whose radiation doses must be reconstructed represents a single case 

requiring a single dose reconstruction, regardless of the number of claimants seeking compensation for the 

cancer(s) incurred by the employee. 
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simple arithmetic might by itself establish that the employee received sufficiently high 

radiation doses for DOL to determine that the cancer of the employee was at least as likely as 

not associated with his radiation dose, and that the claimant should be compensated. 

Conversely, cancers that might only be associated with very high doses of radiation, such as 

prostate cancer, may require a full evaluation of all possible sources of exposure, including 

external, internal, medical and environmental sources, unless very high doses are recorded in 

the original data provided by DOE. 

In cases involving AWEs, NIOSH requests for information are similar. DOE provides 

information that it maintains and helps NIOSH identify additional sources of information on 

the radiological exposures of the AWE employees. 

The majority of the information required to complete a dose reconstruction is provided by 

DOL and either DOE, or DOE and other sources of information on the operations of an 

AWE. Claimants are a third routine source of information. In addition, NIOSH may make 

use of information from research studies, medical screening, and other sources of information 

available to characterize the radiological environments of nuclear weapons work. 

Information Requested from DOL

NIOSH obtains the following information from DOL when DOL refers a case to NIOSH for 

dose reconstruction: 

1. Personal information on the covered employee including the employee’s name, 

gender, address, telephone number, birth date, and social security number; 

2. Identification of each covered facility at which the employee was employed and 

the period of employment at each facility; 

3. Identification of the type or types of cancer (defined by International 

Classification of Disease (ICD-9) codes) of the employee (primary cancers if 

known, or secondary sites-sites to which the cancer spread- if the primary cancer 

is unknown); 

4. Dates of cancer diagnoses; 

5. Ethnicity of the employee, if the primary cancer is a type of skin cancer; 

6. Smoking history, if the primary cancer is lung cancer; and 

7. Personal information on the claimant, if he/she is not the covered employee, 

including the claimant’s name, address, telephone number, relationship to the 

covered employee, and social security number. 

Information Requested from DOE and/or an AWE Source of Data

DHHS and DOE established a Memorandum of Understanding (MOU) to coordinate the 

Departments’ interdependent activities for the implementation of EEOICPA. The MOU is 

facilitating the efforts of DOE and NIOSH to accomplish our work in the most timely and 

efficient way possible. With respect to dose reconstruction, the MOU specifies authorities, 

responsibilities, and procedures for NIOSH to request information for dose reconstructions, 

for DOE to respond to such requests, and for NIOSH to provide DOE with final dose 
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reconstruction reports. The MOU also addresses important issues that can relate to these 

exchanges of information, such as ensuring the protection of individuals’ privacy under the 

Privacy Act, processing security clearances for NIOSH dose reconstruction personnel, and 

managing classified information. 

Case-specific Data Requests 

Under the MOU between DOE and DHHS, NIOSH requests the following information from 

DOE upon receiving a case from DOL: 

1. Individual monitoring data, including individual readings from any personal 

radiation dosimeters the employee wore and individual results from bioassay 

samples (biological samples used to measure personal radiation exposure, such as 

urine samples) and whole-body monitoring of the employee (a method of 

measuring radioactive materials inhaled, ingested, or taken in through the skin or 

lesions). 

2. Records of any diagnostic x-rays that the employee may have been required to 

receive, as a condition of employment, in the course of routine medical 

examinations; alternatively, the individual DOE sites may provide facility-wide 

information on the administration of x-ray examinations over the operating 

history. 

3. Incident investigation records for any radiological incidents in which the energy 

employee was involved. 

Batch Data Requests 

NIOSH also obtains individual monitoring data in batches (e.g., pertaining to all the 

employees of an entire facility or site) from DOE and/or from an AWE source of data. This 

is often necessary when obtaining records from an AWE source, which would typically lack 

the resources to provide records on a case-by-case, as needed, basis. 

Site Profile Data Requests 

NIOSH requests site and facility information from DOE and/or from an AWE source of data 

that is used to interpret and supplement individual employee radiation monitoring data and to 

substitute for such data as necessary. DOE and/or the AWE source of data are requested to 

provide detailed descriptions of the radiation control practices of the facility throughout the 

period of operations. This information includes dosimetry program information such as the 

types and accuracy of radiation dosimeters, the frequency with which the dosimeters were 

read, and bioassay techniques employed. It also includes information on facility operations 

and radiological conditions. Such information includes the amount, types and chemical forms 

of the radioisotopes present at the facility, area radiological monitoring results, and 

environmental radiation levels in and around the facility. All of this information is used to 

develop site profiles, which are site-specific guidance documents used in support of dose 

reconstructions. 
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Information Requested from Claimants

NIOSH obtains the following information from claimants: 

1. Claimants are interviewed to assist NIOSH in interpreting and supplementing 

information provided by DOE, DOL and other sources, including information on 

work performed by the employee, the employee’s involvement in radiological 

incidents and radiation protection practices in place during the employee’s 

employment; 

2. NIOSH provides every claimant the opportunity to review and comment on the 

NIOSH interview report to ensure that NIOSH accurately captures information 

provided by the claimant; 

3. After the draft dose reconstruction report is completed, NIOSH provides every 

claimant the opportunity to review and comment on the draft dose reconstruction 

report to ensure that any information provided by the claimant and subsequently used 

in the dose reconstruction is accurate and to help the claimant understand the 

information, methods, and results of the dose reconstruction; 

4. NIOSH asks every claimant to review and sign the “Statement by the Claimant 

Closing the Record on a NIOSH Dose Reconstruction under the Energy Employees 

Occupational Illness Compensation Program Act” (the “OCAS-1 form”). This 

statement verifies that the claimant has completed providing information to NIOSH 

for the dose reconstruction. After receiving the signed statement from the claimant, 

NIOSH will forward the completed dose reconstruction report to DOL and the 

claimant. 

III. Identification of Matters Adversely Affecting the Ability of NIOSH to Obtain 

Information in a Timely, Accurate, and Complete Manner 

Many matters have affected NIOSH’s ability to obtain information in a timely, accurate, or 

complete manner, for completing an individual dose reconstruction or for being able to 

complete a group of individual dose reconstructions associated with a particular nuclear 

weapons facility or site. These factors are described in detail below and within the context of 

the dose reconstruction process under section IV of this report. 

It should be understood that, in this report, obtaining information in an accurate and complete 

manner means obtaining information that NIOSH has requested, sufficient to conduct a dose 

reconstruction. It is not typical for individual dosimetry data to be accurate or complete, 

particularly data that are decades old, because the technology and practices of radiation 

monitoring have improved over time, and because these practices have been designed to 

prevent exposures above regulatory limits, rather than to track radiation doses accurately. 

However, it is not necessary for such data to be accurate and complete in order to complete a 

dose reconstruction. Dose reconstruction is a practice specifically intended to estimate doses 

when monitoring information is missing, incomplete, or inaccurate. In this process of 

estimation, one type of information, such as information on dosimetry practices or work 

processes, is used to correct or substitute for another type of information, such as individual 

monitoring or area monitoring records. Uncertainties in information are identified when 
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present and taken into account when they could substantially affect the result of the dose 

reconstruction. 

When NIOSH does not receive information it has requested, this delays NIOSH in 

conducting the dose reconstruction or group of dose reconstructions related to the 

information request. As is discussed below, however, dose reconstructions have also been 

delayed by the development of the infrastructure needed for the dose reconstruction program, 

and the collection and analysis of data to establish site profiles. 

Matters Concerning Information from DOL

The following matters concern information supplied by DOL: 

1. Information provided by the Department of Labor (DOL) is occasionally 

inaccurate or incomplete: This information, as described above, includes contact 

information, employment history, cancer diagnosis, and when applicable, 

smoking history or ethnicity. Deficiencies in this information have typically 

involved either incomplete employment or cancer diagnosis information, and 

often occur when the sources of information upon which DOL relies are 

inaccurate or incomplete. These situations are typically identified through the 

dose reconstruction process, which involves NIOSH interviewing the claimants 

and reviewing more extensive employment-related records than are germane to 

DOL processes for determining that an employee is eligible to be considered for 

compensation. NIOSH then asks DOL to supplement the record to reflect this 

new information, since DOL has the responsibility for verifying employment and 

medical conditions. 

2. Additional cancer diagnosed during case processing: Some energy employees 

have been diagnosed with an additional cancer after the initial case file was 

submitted to NIOSH by DOL. Since radiation doses are estimated for the specific 

cancer site or sites relevant to the case, NIOSH must revise the dose 

reconstruction to include dose estimates for the new cancer site. 

Matters Concerning information from DOE or Sources of AWE Data

The following matters concern information supplied by DOE or sources of data for cases 

involving AWEs: 

1. Data does not exist in a readily retrievable format: Several DOE facilities have 

maintained data in filing systems that were not designed for the efficient 

collection of data relating to individual employees. For example, some sites filed 

data by time period (month, quarter or year) rather than by any individual 

identifier such as name, social security number, badge number etc. In these 

circumstances, extensive sets of files have to be searched to fulfill each individual 

request for dosimetry data. DOE is working to convert such filing systems to 

support more efficient retrieval of data for individuals. 
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2. Individual exposure records cannot be located: In some cases, some or all records 

of work and/or exposure for an individual cannot be located. In such cases, as 

specifically allowed by EEOICPA, NIOSH requires co-worker exposure data 

and/or other data to characterize the potential exposures of the energy employee. 

The development of substitute information is time-consuming. 

3. DOE was providing dosimetry data from some of its sites in summary form: 

NIOSH requests dosimetry data in the form of individual measurements from 

radiation monitors and bioassays, rather than summaries of this information that 

are more frequently used by DOE for other purposes. The individual 

measurements are much more readily usable in dose reconstructions and are more 

precise information. DOE sites are now consistently providing data in the 

requested form, when it is available. When it is not available, NIOSH has to 

substitute other types of information and analytic work. 

4. Limitations concerning AWEs: DOE often does not have detailed information 

concerning radiological exposures at AWEs, and some AWEs are no longer in 

business or may have little incentive to promptly search and provide their records. 

DOE helps NIOSH to identify additional sources of information and to obtain the 

information available. These operations are time-consuming. In addition, the 

records available for AWEs are likely to be less extensive than are generally 

available for DOE facilities because many AWEs operated during the first years 

of the U.S. nuclear weapons program, when radiological monitoring and 

protection programs were relatively unsophisticated. 

5. Administrative matters affecting the provision of information by DOE: In 

addition to the matters described above, DOE previously has reported that 

resource limitations and other administrative matters have affected the provision 

of information requested for dose reconstruction. DOE has worked to effectively 

resolve these administrative matters when they arise. 

Matters Concerning Information from Claimants

The following matters concern information provided by claimants: 

1. Claimants may not know or cannot recall information that might be useful or may 

inadvertently provide inaccurate information: Many claimants are survivors and 

the majority of survivors were not well informed of the employee’s work 

experience (most employees kept many details of their work experiences 

confidential for the protection of national security). In addition, some employees 

were not informed or well informed about their radiation exposures and other 

relevant information, and many of these employees are elderly and may have 

difficulty remembering correctly the details of their work experiences. While the 

claimant interviews are voluntary and dose reconstructions can rely on other 

sources of information, the limitations concerning the knowledge of claimants can 

delay the progress of the dose reconstruction. In particular, NIOSH may have to 

interview co-workers or seek additional records to establish the work history of 

the employee or may have to conduct additional analyses to take into account 

uncertainties about the work history. 
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2. Claimants may provide additional information after the dose reconstruction is 

drafted: After receiving NIOSH’s draft dose reconstruction report, claimants 

sometimes provide additional information. NIOSH considers the relevance of this 

information to the dose reconstruction and revises the dose reconstruction if 

necessary. The late provision of this information delays the completion of the 

dose reconstruction. 

3. Claimants may not return the OCAS-1 form within 60 days: A claimant has 60 

days to sign and return the OCAS-1 form indicating that the claimant has no 

additional information to provide for the dose reconstruction. After sixty days, 

NIOSH sends two reminder letters (the first at 60 days and another at 74 days) to 

the claimant notifying the claimant that the dose reconstruction and case may be 

administratively closed if the claimant does not sign and return the OCAS-1 form. 

The sooner the claimant signs and returns the OCAS-1 form, the sooner NIOSH 

forwards the case to DOL for a decision. Sometimes this step is delayed for cases 

involving multiple claimants (survivors) associated with a particular case, 

because, in general, a case is not forwarded to DOL until an OCAS-1 form has 

been received from each claimant. NIOSH will, however, forward a case to DOL 

after all of these steps have been completed, provided that NIOSH has received at 

least one signed OCAS-1 form from among a group of multiple claimants. 

Matters Concerning the Development of a Dose Reconstruction Program by NIOSH

In addition to issues related to obtaining information in a timely, complete and accurate 

manner, NIOSH has had to develop the infrastructure, analyses, and protocols required to 

process and apply this information efficiently in dose reconstructions. The progress of 

this developmental work has been the single most important matter affecting the pace of 

dose reconstructions. The following is the status of this developmental work: 

 

1. The infrastructure needed to complete dose reconstructions has been developed.

EEOICPA was enacted October 30, 2000, and Executive Order 13179, which 

assigned DHHS its responsibilities under EEOICPA, was issued on December 7, 

2000. NIOSH developed the data management systems, basic procedures for dose 

reconstructions, and published final rules concerning methods for dose reconstruction 

and probability of causation determinations, in 2001 and 2002. NIOSH completed the 

development of internal facilities and the recruitment of staff in 2003. 

NIOSH awarded a large support contract in September of 2002 to obtain the majority 

of the resources required to handle the high volume of cases referred by DOL for 

dose reconstruction. The contractor completed hiring and training its staff and 

developing its facilities and primary systems in 2003. 

2. The development of site profiles is underway. NIOSH is in the process of producing 

site profiles, which summarize the operational history, radiation control procedures, 

dosimetry practices, and other general information related to radiation exposures, for 

all major DOE and AWE sites. These site profiles provide the health physicists who 

conduct dose reconstructions with consistent general information to support their 
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completion of individual dose reconstructions. NIOSH is developing first the profiles 

for sites for which NIOSH has the largest number of dose reconstruction cases. The 

pace at which NIOSH can complete these site profiles is limited, however, by the 

limited expert resources available to conduct this exceptionally specialized work, the 

complexity of the history and variety of operations at particular sites, and other 

factors. 

As of January 31, 2004, NIOSH had completed site profiles for two major DOE sites 

and four AWEs. Site profiles are underway or scheduled for completion in 2004 for 

other DOE sites and AWEs. 

IV. Overview of Dose Reconstruction Process 

The following overview of the dose reconstruction process explains how NIOSH 

processes EEOICPA cases and identifies the points at which matters that adversely affect 

the work, as identified under Section III of this report, can occur. This context is 

important for understanding the normal operation of the NIOSH dose reconstruction 

program at this point in time, as well as for understanding how the given matters affect 

the accurate, complete, and timely acquisition of information needed for dose 

reconstructions. A time line illustrating this process is included as Attachment 1, “Dose 

Reconstruction Processing Time Line Goals.” The AT=@ notations below signify the time 

in days after receipt from DOL, during which each action is expected to take place when 

there are no delaying circumstances. 

1. Case is received from the DOL (T=0): The starting point of NIOSH’s dose 

reconstruction process is when NIOSH receives the case from DOL. NIOSH then 

assigns the case an identification number and enters it into the NIOSH Tracking 

Database. 

2. Request Data from DOE (T=1): A NIOSH request for data from DOE is 

automatically generated and sent to the appropriate DOE facility point of contact. 

In cases where the employee worked at more than one facility, multiple dose 

information requests must be made. DOE is requested to provide a response 

within 60 calendar days. This response depends on the availability of the data and 

may include: 1) the data requested; 2) an indication that no data was found; or 3) 

an indication that the search is continuing. In some circumstances, typically 

involving AWE facilities, NIOSH, with the assistance of DOE, has to identify a 

point of contact (a source for records), which delays the process of requesting 

records. It may take considerable investigation to identify the repository or 

repositories of data, particularly for operations that were discontinued decades 

ago and for employers no longer in business. In other circumstances, NIOSH 

does not obtain data for cases individually, either because the data is being 

obtained through a facility-wide data capture effort or because NIOSH has been 

informed that personal dosimetry data is not available. 
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3. Receive DOE Data (T=61): When NIOSH receives the records from DOE, it 

scans the images into a tracking database and reviews the data for quality. A 

period of seven calendar days is allotted for this initial quality review (quality 

issues may also be addressed at the time a health physicist conducts the dose 

reconstruction). If inadequacies are identified, such as when individual exposure 

records are not located or are not of the type requested, NIOSH sends an 

additional request for information to DOE. The additional request can cause 

substantial delay at this step, particularly if the inadequacy of the initial response 

from DOE relates to a systemic limitation on data retrieval of the type previously 

described in this report. Also, an important cause of delay at this step had been 

the initial lack of an infrastructure at NIOSH to review the adequacy of records 

received from DOE and the resulting backlog of cases that has accrued during this 

infrastructure development. The infrastructure was put into place in 2003 through 

contract support and this review work is proceeding, as discussed later in this 

report. Similarly, DOE also had to develop capacity to respond to NIOSH 

requests for DOE data or to identify other sources of data on AWEs. 

4. Send initial interview letter to claimant (T=68): NIOSH attempts to interview all 

claimants to obtain any information they might have that would supplement or 

correct information available from other sources that might be used in the dose 

reconstruction. NIOSH sends a letter informing the claimant that someone will be 

contacting them to conduct an interview and provides a list of the questions that 

will be asked during the course of the interview. The claimant normally is 

provided 14 calendar days (from the date of mailing) to review the questions. An 

incorrect mailing address (due to a change of address) is presently the principal 

cause of delays relating to this step, requiring NIOSH to relocate the claimant 

through DOL or other sources. Previously, the development of the infrastructure 

required to conduct a high volume of interviews was the principal cause of delay 

at this step. 

5. Schedule claimant interview (T=68-82): During the claimant’s review of the 

interview questions, NIOSH contacts the claimant by telephone to schedule the 

interview. This call can be delayed when the claimant has a change of phone 

number and when the claimant is unavailable. If the claimant cannot be contacted 

by phone, NIOSH sends a follow-up letter, at least 14 days after the initial 

interview letter, explaining that attempts to contact the claimant by phone were 

unsuccessful and that the case will be forwarded for dose reconstruction, unless 

the claimant contacts NIOSH at the number provided to schedule the interview. 

6. Conduct Claimant Interview (T= 83-90): NIOSH attempts to schedule interviews 

of claimants during the third week after the initial interview letter was mailed. 

After the interview is completed, NIOSH summarizes the interview in a written 

report, which is sent to the claimant for review within seven days. NIOSH 

requests the claimants to provide comments if the report omits important 

information or is inaccurate. Delays at this step usually result from the claimant 
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being unavailable at the scheduled interview time or as a result of iterative 

interactions with claimants who supplement the interview record. 

7. Send Dose Reconstruction Introduction Letter to Claimants (T=91): After the 

interview has been completed and documented, and sufficient data is believed to 

exist to begin a dose reconstruction, NIOSH sends a letter to the claimant 

providing a list of health physicists who may be assigned to perform the dose 

reconstruction. This letter includes a brief description of the health physicists who 

may be assigned to the case and the facilities where the health physicists have 

worked. NIOSH asks whether the claimant would view any of the proposed health 

physicists as having a conflict of interest in conducting the dose reconstruction. 

Claimants have 14 calendar days to respond to this query. If no response is 

received, NIOSH assumes the claimant does not view any of the proposed health 

physicists as having a conflict of interest. NIOSH has not experienced significant 

delays associated with this step, but has experienced significant delays in 

initiating this step since most dose reconstructions require the use of a site profile. 

8. Conduct dose reconstruction (T = 105-165) NIOSH assigns the case to a health 

physicist, and the dose reconstruction is started. Once drafted, the dose 

reconstruction undergoes multiple levels of quality review by health physicists 

with the contractor and at NIOSH. Delays in completing a draft dose 

reconstruction can result from newly identified inaccuracies or omissions in 

information concerning exposures, cancer diagnosis, employment periods, and 

demographic information, and the identification of new cancers diagnosed since 

the claim was submitted. Delays also can arise from quality reviews and as 

individual dose reconstructions broach new technical issues requiring procedural 

determinations by senior health physicists. Finally, dose reconstructions that 

require highly specialized expertise have been delayed while the relevant experts 

have developed methods that can be applied by their colleagues. 

9. Obtain any additional relevant information from the claimant prior to completing 

the dose reconstruction (T=166-226) NIOSH sends the completed draft dose 

reconstruction report to the claimant, together with an OCAS-1 form, which 

enables the claimant to certify that he/she has provided all relevant information so 

that the dose reconstruction can be finalized and the case referred back to DOL. 

NIOSH conducts a closing interview with the claimant to explain the dose 

reconstruction methods and results and obtain any additional information the 

claimant might provide. If the claimant does not provide additional information 

relevant to the dose reconstruction, the claimant has 60 days to sign and return the 

OCAS-1 form to NIOSH. Delays at this step result when the claimant does not 

return the OCAS-1 form to NIOSH within 60 days, is not available to conduct a 

closing interview, makes alterations to the OCAS-1 form that require follow-up, 

or provides additional information that might be relevant to the dose 

reconstruction. 
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10. Complete the dose reconstruction and refer the case back to DOL (T=227-228) 

Once a signed OCAS-1 form is returned by the claimant or claimants for a case, 

the NIOSH analysis record for the dose reconstruction is closed and a final dose 

reconstruction report is sent to DOL, DOE, and the claimant. This final step is 

normally completed within two days of receiving the signed OCAS-1 form. 

Delays at this step can occur when a signed OCAS-1 form is returned prior to the 

closing interview. 

V. Data Quality Review 

NIOSH has reviewed the quality of the DOE responses for dosimetry data on a site-by-site 

basis, in accordance with the order in which site profiles are being developed. NIOSH has 

reviewed the majority of case-specific data received from DOE for those sites for which site 

profiles have been issued or are expected to be issued soon. Alternatively, NIOSH has 

reviewed a representative sample of the data received from DOE for those sites for which site 

profiles are expected to be completed later in 2004. 

The data associated with each case is thoroughly reviewed prior to being forwarded on for 

dose reconstruction. This review is performed to determine if the information provided is 

adequate to perform a dose reconstruction. The information associated with a case will be 

considered adequate if any one of the following criteria is met: 

1. The data requested is provided and is sufficiently detailed to perform a dose 

reconstruction for compensation purposes. 

2. If personal dosimetry information (regarding the employee and/or coworkers at 

the facility) is not available, NIOSH has approved a site profile applicable to the 

covered employee’s place(s) of employment and particular cancer. 

3. Limited available dosimetry information results in a dose estimate sufficiently 

high to produce a probability of causation of 50% or greater. 

Sites Providing Adequate Responses to Data Requests for Dose Reconstruction 

(determined by a review of almost all cases) 

As of January 15, 2004, NIOSH had reviewed 96% of the 8,198 DOE submittals from the 

sites listed below and had determined that all of the DOE submittals reviewed are adequate 

for the initiation of the dose reconstruction. About 4,600 cases associated with these sites are 

awaiting the completion of site profiles. Approximately 400 cases are awaiting additional 

information from sources other than DOE, such as cancer diagnosis information that would 

come from DOL. The number of cases associated with each site is indicated in 

Attachment 2. 

• Savannah River 

• Hanford 

• Y-12 Plant 

• Oak Ridge National Laboratory (X-10) 

• Rocky Flats Plant 
 Page 14 of 17 

• Oak Ridge Gaseous Diffusion Plant (K-25) 

• Pacific Northwest National Laboratory 

 

Sites Providing Adequate Responses to Data Requests for Dose Reconstruction 

(determined by a review of a random sample of cases) 

As of November 30, 2003, NIOSH had reviewed a random sample of 1,598 (36%) of 4,450 

DOE submittals, stratified across sites listed below, to evaluate the adequacy of the DOE 

submittals for dose reconstruction. NIOSH determined that the data from these sites should 

be adequate for the initiation of dose reconstruction for a large majority of claims. At least 

1,416 of the submittals reviewed (89%) appear to be adequate. (Adequacy cannot be fully 

evaluated until the site profiles for these sites are completed.) The number of cases 

associated with each site is indicated in Attachment 2. 

• Idaho National Engineering Laboratory 

• Nevada Testing Site 

• Feed Materials Production Center (FMPC) 

• Mound Plant 

• Paducah Gaseous Diffusion Plant 

• Portsmouth Gaseous Diffusion Plant 

• Kansas City Plant Energy Technology Engineering Center 

• Lawrence Livermore National Laboratory 

• Argonne National Laboratory – East 

• Pinellas Plant 

• Sandia National Laboratory 

• Clarksville Facility 

• Argonne National Laboratory – West 

• Sandia National Laboratory – Livermore 

• Pacific Proving Ground 

• Median Facility 

• Grand Junction Operations Office 

• West Valley Demonstration Project 

• Albuquerque Operations Office 

• Oak Ridge Institute for Science and Education 

• Oak Ridge Thermal Diffusion Plant (S-50) 

• Lawrence Berkeley National Laboratory 

• Ames Laboratory 

• Sandia Laboratory – Salton Sea Base 

• Lovelace Respiratory Research Institute 

• Fermi National Accelerator Laboratory 

• Environmental Measurements Laboratory 

• Yucca Mountain Site Characterization Project 
 Page 15 of 17 

Sites with Special Consideration

The following represent sites where monitoring data was obtained through sources other than 

DOE, as identified below. NIOSH has reviewed records on 684 individuals and found 674 

(99%) of these to be adequate to initiate dose reconstructions. 

• Mallinckrodt (data source: Environmental Measurements Laboratory)

• Iowa Ordinance Plant (data sources: University of Iowa, the Department of Defense, Oak Ridge 

Associated Universities)

• Shippingport Atomic Power Plant (data source: Atlanta National Archives)

Sites Not Providing Data Requested for Dose Reconstruction

There is one site, the Trinity Nuclear Explosion Site, with 1 request for information, for 

which no DOE submittals have been received. 

Sites Not Consistently Providing Adequate Responses to Data Requests for Dose 

Reconstruction

(determined by a review of a random sample of cases) 

The sites listed below are not providing the data requested for dose reconstruction for a 

substantial proportion of cases. NIOSH has reviewed a random sample of 364 (42%) of the 

876 DOE submittals from these sites, as well as the submittals responding to a total of three 

requests to Los Alamos Medical Center. Of the sample of submittals reviewed, 259 (71%) 

appear to be adequate for the initiation of dose reconstruction. The number of cases 

associated with each site is indicated in Attachment 2. 

• Los Alamos National Laboratory 

• Los Alamos Medical Center 

• Pantex Plant 

• Brookhaven National Laboratory 

• Stanford Linear Accelerator Facility 

• Oak Ridge Hospital 

Some of the specific deficiencies of the data provided by these sites that could result in 

delays in dose reconstructions are as follows: 

 

• Los Alamos National Laboratory has not submitted individual bioassay data, nor 

detailed external dosimetry data. The submittals consist of derived dose quantities, 

which cannot readily be used in dose reconstructions because they use a different 

methodology than NIOSH uses for dose reconstructions. 

• Los Alamos Medical Center has submitted derived dose quantities instead of 

individual bioassay data and detailed external dosimetry data for one of three cases 

for which it received requests. 

• Pantex Plant has submitted inconsistent data. For a substantial number of cases, 

monitoring data provided in summary form are inconsistent with detailed data. 
 Page 16 of 17 

• Brookhaven National Laboratory has not submitted raw bioassay data, nor detailed 

external dosimetry data. The submittals have consisted of summary data, which 

cannot be readily used in dose reconstructions. 

• Stanford Linear Accelerator Facility has provided only summary data. 

• Oak Ridge Hospital has provided only summary data. 

DOE Support of the Development of Site Profiles

Throughout 2003, NIOSH worked on the development of 14 profiles for DOE sites. As 

discussed in Sections II and III, these site profiles provide a summary and compilation of 

basic dosimetry and related information used to assist health physicists in conducting 

individual dose reconstructions for employees at the sites. DOE has been supportive in 

assisting NIOSH to locate and obtain the site characterization information. There have been 

delays in this process, however, to comply with procedures for assuring national security 

when information requested is in classified documents. 

VI. Data Requested on the Performance of the NIOSH Dose Reconstruction Program 

Total Number of Claims Requiring Dose Reconstruction

As of January 15, 2004 NIOSH had received 15,191 cases for dose reconstruction from the 

DOL. Attachment 2 provides a site specific breakdown of these cases. 

Total Number of Dose Reconstructions Adversely Affected by Matters Addressed in this 

Report

Almost all of the 15,191 cases received from DOL as of January 15, 2004 have been 

adversely affected by one or more of the matters addressed in this report, resulting in a delay 

of the dose reconstruction process outlined in Section IV of this report. It is not possible, 

however, to specify further the number of cases at each facility that were affected specifically 

by any particular matter. More than one of the matters identified in Section III of this report 

can affect a single claim and many of these matters are not tracked. For example, most of the 

claims referred to NIOSH by DOL have been delayed while NIOSH has developed the 

infrastructure and site profiles required to conduct the dose reconstructions. 

As indicated in Section IV of this report, a substantial proportion of cases would have been 

likely to require more than 150 days for completion without the occurrence of any delay, to 

provide for the full rights and involvement of claimants and/or the complexity of the 

particular dose reconstruction. Also, as indicated in Section III of this report, there are a 

number of factors that caused delays in obtaining information in a timely, complete and 

accurate manner, and NIOSH has had to develop the infrastructure, analyses, and protocols 

required to process and apply this information efficiently in dose reconstructions. By 

continuing to address these issues, NIOSH has greatly improved the completion rate for dose 

reconstructions. While it took NIOSH a little more than two years from when it received its 

first referral from DOL to complete the first 1000 dose reconstructions, NIOSH completed 

the second 1000 dose reconstructions in less than four months. NIOSH is hopeful that these 
 Page 17 of 17 

improvements throughout the program will result in future dose reconstructions being 

completed as expeditiously as possible. 

VII. Conclusion 

NIOSH, with the cooperation of DOL, DOE, EEOICPA claimants, and other sources of data, 

is completing more dose reconstructions while continuing to develop the capacity of the dose 

reconstruction program authorized under EEOICPA. The progress of this endeavor, 

however, has not been as rapid as planned. Although NIOSH foresaw substantial challenges 

in creating a dose reconstruction program of this unprecedented scale at the time EEOICPA 

was enacted, far more extensive developmental work than anticipated has proven necessary. 

Specifically, NIOSH has found that it must complete the development of a site profile, as 

discussed in Section II of this report, prior to completing most dose reconstructions for 

employees who worked at the site addressed by the site profile. NIOSH is working to 

complete site profiles as quickly as possible. 

NIOSH is also making every effort to continue to expedite the completion of dose 

reconstructions for which site profiles are completed or other sources of information are 

sufficient. NIOSH is dedicated to providing the best possible scientific and technical service 

to the EEOICPA program and its claimants.